• Medical Review Nurse

    Molina Healthcare (Atlanta, GA)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
    Molina Healthcare (09/06/25)
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  • Dialysis HHD PD Registered Nurse

    Fresenius Medical Center (Cumming, GA)
    …Case Manager for patients with various shifts and work hours **PURPOSE AND SCOPE:** The registered professional nurse (CAP RN 1) position is an entry level ... designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is...years. + Minimum of 9 months experience as a Registered Nurse (preferred). + Chronic Home dialysis… more
    Fresenius Medical Center (10/25/25)
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  • Bed Planning Coordinator Registered

    Emory Healthcare/Emory University (Atlanta, GA)
    …and leadership programs + And more **Description** We're seeking a **Bed Planning Coordinator ( Registered Nurse / RN )** who provides 24/7 coverage for the ... appropriate patient flow, working closely with the Transfer Services RN Coordinator and Patient Flow Coordinator to manage the...location/level of care. + Uses advanced clinical knowledge and medical chart review to direct proper patient… more
    Emory Healthcare/Emory University (10/30/25)
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  • Inpatient Registered Nurse

    Fresenius Medical Center (Atlanta, GA)
    …1968 Peachtree Rd NW, Atlanta, GA 30309** **PURPOSE AND SCOPE:** The Inpatient RN provides direct patient care in accordance to company policies and procedures which ... dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to… more
    Fresenius Medical Center (10/22/25)
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  • Registered Nurse Consultant…

    Vatica Health (Atlanta, GA)
    …+ Minimum of 3 years of recent adult health clinical experience as a Registered Nurse ( RN )- preferably in critical care (ie, ICU/CCU/MICU) and/or ... Are you an RN looking for a career opportunity in healthcare...and detailed-oriented nurses to join our team. As a Nurse Consultant, you will collect, review and… more
    Vatica Health (09/08/25)
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  • Clinical Fraud Investigator II - Registered

    Elevance Health (Atlanta, GA)
    **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
    Elevance Health (11/04/25)
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  • Medical Management Nurse

    Elevance Health (Atlanta, GA)
    …have License to practice in the state of Georgia** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging cases that ... whether treatment is medically necessary and provides consultation to Medical Director on cases that are unclear or do...Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate… more
    Elevance Health (10/28/25)
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  • Bilingual Plasma Center Nurse , RN

    BioLife Plasma Services (Duluth, GA)
    …+ Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or Physician ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
    BioLife Plasma Services (09/12/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Atlanta, GA)
    For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • Dialysis Charge Nurse RN

    Dialysis Clinic, Inc. (Atlanta, GA)
    …experience; experience preferred **Benefits:** + Paid training with preceptor + Charge nurse continuing education classes + Comprehensive medical , dental and ... to physician; implement and document orders + Participate in patient care conferences, medical rounds and chart review ; document progress notes + Contribute to… more
    Dialysis Clinic, Inc. (10/15/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary The Care Review Clinician RN provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
    Molina Healthcare (11/04/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
    Molina Healthcare (11/06/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Atlanta, GA)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (10/26/25)
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  • Care Review Clinician ( RN ) - Must…

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (11/04/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Atlanta, GA)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (11/04/25)
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  • Full Time Plasma Center Nurse ( RN

    BioLife Plasma Services (Duluth, GA)
    …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
    BioLife Plasma Services (10/22/25)
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  • Manager, Fraud & Waste Investigation…

    Humana (Atlanta, GA)
    …Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. **Required Qualifications** + Registered Nurse ( RN ), holding an active and unrestricted ... resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to ensure… more
    Humana (11/04/25)
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  • RN Clinical Manager, Home Health

    CenterWell (Duluth, GA)
    …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and...A minimum of 2 years of experience as a Registered Nurse ( RN ). + Home… more
    CenterWell (10/29/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Atlanta, GA)
    …an impact** **Use your skills to make an impact** **Required Qualifications** + **​Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
    Humana (09/12/25)
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  • Clinical Reviewer, Nurse ( Medical

    Evolent (Atlanta, GA)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for performing precertification and prior approvals. Tasks are performed within the RN /LVN/LPN scope of practice, under Medical Director direction, using… more
    Evolent (10/21/25)
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